Examining intra- and inter-personal health effects of optimism and pessimism: The role of subjective well-being in romantic couples.

INTRODUCTION: Recent meta-analytic research suggests that the absence of pessimism could be a stronger predictor of physical health than the presence of optimism. The present study examined the role of subjective well-being in the effects of optimism and pessimism on physical health in romantic couples. It was hypothesized that pessimism would be more strongly associated with both well-being and health than optimism, intra- and interpersonally. Subjective well-being was also expected to explain variance in the associations between optimism, pessimism, and health. METHODS: A baseline sample of 153 opposite-sex couples completed various measures of subjective well-being (e.g., life satisfaction, positive and negative affect, and depressive symptoms) and physical health (e.g., subjective health, sleep efficiency, physical symptoms, cold symptoms, and chronic illness). RESULTS: Results of actor-partner interdependence models showed that the absence of pessimism, but not the presence of optimism, was associated with better physical health at baseline and over time. Pessimism was also a stronger predictor than optimism of baseline levels in some indicators of subjective well-being. These effects were obtained intra- and interpersonally. Finally, subjective well-being explained variance in some of the effects of pessimism on levels of physical health. Implications for theory, research, and practice are discussed.

It remains meaningful to distinguish optimism from pessimism: Reply to VanderWeele and Kubzansky (2021).

VanderWeele and Kubzansky (2021) provide a commentary on Scheier et al. (2021), in which they introduce the distinction between what they term comparative and absolute optimism. We believe that more conceptual and empirical work is needed before a full understanding of the meaning and implications of the terms can be known. In contrast, the construal of optimism and pessimism as separate but related dimensions is founded on decades of research. Moreover, as shown in Scheier et al. (2021), the absence of pessimism is a better predictor of physical health outcomes than is the presence of optimism, which in turn has implications for how interventions might be devised. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Optimism versus pessimism as predictors of physical health: A comprehensive reanalysis of dispositional optimism research.

Prior research has related dispositional optimism to physical health. Traditionally, dispositional optimism is treated as a bipolar construct, anchored at one end by optimism and the other by pessimism. Optimism and pessimism, however, may not be diametrically opposed, but rather may reflect 2 independent, but related dimensions. This article reports a reanalysis of data from previously published studies on dispositional optimism. The reanalysis was designed to evaluate whether the presence of optimism or the absence of pessimism predicted positive physical health more strongly. Relevant literatures were screened for studies relating dispositional optimism to physical health. Authors of relevant studies were asked to join a consortium, the purpose of which was to reanalyze previously published data sets separating optimism and pessimism into distinguishable components. Ultimately, data were received from 61 separate samples (N = 221,133). Meta-analytic analysis of data in which optimism and pessimism were combined into an overall index (the typical procedure) revealed a significant positive association with an aggregated measure of physical health outcomes (r = .026, p < .001), as did meta-analytic analyses with the absence of pessimism (r = .029, p < .001) and the presence of optimism (r = .011, p < .018) separately. The effect size for pessimism was significantly larger than the effect size for optimism (Z = -2.403, p < .02). Thus, the absence of pessimism was more strongly related to positive health outcomes than was the presence of optimism. Implications of the findings for future research and clinical interventions are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Charles S. Carver (1947-2019).

Presents an obituary for Charles S. Carver (1947-2019). Carver was known for his pioneering theory and research on behavioral self-regulation as reflected in goal-directed action. Carver has been honored by the American Psychological Association (APA), Divisions 38 (Society of Health Psychology) and 8 (Society for Personality and Social Psychology), for his career contributions to the areas of health, social, and personality psychology. Carver served for 6 years as the editor of the Personality Processes and Individual Differences section of the Journal of Personality and Social Psychology and another 6 years as an associate editor of Psychological Review. He authored 10 books and over 425 articles and chapters. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

On the Mechanics of Goal Striving: Experimental Evidence of Coasting and Shifting.

Carver and Scheier's (1990) account of goal striving predicts that unexpectedly fast goal progress leads to reduced effort at that goal (coasting) and to shifting focus toward other goals (shifting). Although these hypotheses are key to this goal-striving account, empirical evidence of coasting and shifting is scarce. Here we demonstrate coasting and shifting in 2 experiments: Participants performed a lexical decision task and were promised a bonus if they delivered a specific number of correct responses (accuracy goal) and a specific number of fast responses (speed goal). After half of the trials, participants received (randomly allocated) feedback on their progress regarding the 2 goals, in which progress toward 1 goal was either above or below the target. In line with hypotheses, better-than-needed progress toward 1 goal led to (a) reduced subsequent progress toward that goal (as reflected in lower goal-related performance; coasting) and (b) a shift of resources toward the alternative goal (as reflected in higher goal-related performance on the alternative goal; shifting). Experiment 1 further demonstrated that positive feedback led to positive affect, and Experiment 2 demonstrated the causal role of affect in coasting and shifting. The implications of the present findings for future research on goal striving are discussed.

Long-term primary results of accelerated partial breast irradiation after breast-conserving surgery for early-stage breast cancer: a randomised, phase 3, equivalence trial.

BACKGROUND: Whole-breast irradiation after breast-conserving surgery for patients with early-stage breast cancer decreases ipsilateral breast-tumour recurrence (IBTR), yielding comparable results to mastectomy. It is unknown whether accelerated partial breast irradiation (APBI) to only the tumour-bearing quadrant, which shortens treatment duration, is equally effective. In our trial, we investigated whether APBI provides equivalent local tumour control after lumpectomy compared with whole-breast irradiation. METHODS: We did this randomised, phase 3, equivalence trial (NSABP B-39/RTOG 0413) in 154 clinical centres in the USA, Canada, Ireland, and Israel. Adult women (>18 years) with early-stage (0, I, or II; no evidence of distant metastases, but up to three axillary nodes could be positive) breast cancer (tumour size ≤3 cm; including all histologies and multifocal breast cancers), who had had lumpectomy with negative (ie, no detectable cancer cells) surgical margins, were randomly assigned (1:1) using a biased-coin-based minimisation algorithm to receive either whole-breast irradiation (whole-breast irradiation group) or APBI (APBI group). Whole-breast irradiation was delivered in 25 daily fractions of 50 Gy over 5 weeks, with or without a supplemental boost to the tumour bed, and APBI was delivered as 34 Gy of brachytherapy or 38·5 Gy of external bream radiation therapy in 10 fractions, over 5 treatment days within an 8-day period. Randomisation was stratified by disease stage, menopausal status, hormone-receptor status, and intention to receive chemotherapy. Patients, investigators, and statisticians could not be masked to treatment allocation. The primary outcome of invasive and non-invasive IBTR as a first recurrence was analysed in the intention-to-treat population, excluding those patients who were lost to follow-up, with an equivalency test on the basis of a 50% margin increase in the hazard ratio (90% CI for the observed HR between 0·667 and 1·5 for equivalence) and a Cox proportional hazard model. Survival was assessed by intention to treat, and sensitivity analyses were done in the per-protocol population. This trial is registered with ClinicalTrials.gov, NCT00103181. FINDINGS: Between March 21, 2005, and April 16, 2013, 4216 women were enrolled. 2109 were assigned to the whole-breast irradiation group and 2107 were assigned to the APBI group. 70 patients from the whole-breast irradiation group and 14 from the APBI group withdrew consent or were lost to follow-up at this stage, so 2039 and 2093 patients respectively were available for survival analysis. Further, three and four patients respectively were lost to clinical follow-up (ie, survival status was assessed by phone but no physical examination was done), leaving 2036 patients in the whole-breast irradiation group and 2089 in the APBI group evaluable for the primary outcome. At a median follow-up of 10·2 years (IQR 7·5-11·5), 90 (4%) of 2089 women eligible for the primary outcome in the APBI group and 71 (3%) of 2036 women in the whole-breast irradiation group had an IBTR (HR 1·22, 90% CI 0·94-1·58). The 10-year cumulative incidence of IBTR was 4·6% (95% CI 3·7-5·7) in the APBI group versus 3·9% (3·1-5·0) in the whole-breast irradiation group. 44 (2%) of 2039 patients in the whole-breast irradiation group and 49 (2%) of 2093 patients in the APBI group died from recurring breast cancer. There were no treatment-related deaths. Second cancers and treatment-related toxicities were similar between the two groups. 2020 patients in the whole-breast irradiation group and 2089 in APBI group had available data on adverse events. The highest toxicity grade reported was: grade 1 in 845 (40%), grade 2 in 921 (44%), and grade 3 in 201 (10%) patients in the APBI group, compared with grade 1 in 626 (31%), grade 2 in 1193 (59%), and grade 3 in 143 (7%) in the whole-breast irradiation group. INTERPRETATION: APBI did not meet the criteria for equivalence to whole-breast irradiation in controlling IBTR for breast-conserving therapy. Our trial had broad eligibility criteria, leading to a large, heterogeneous pool of patients and sufficient power to detect treatment equivalence, but was not designed to test equivalence in patient subgroups or outcomes from different APBI techniques. For patients with early-stage breast cancer, our findings support whole-breast irradiation following lumpectomy; however, with an absolute difference of less than 1% in the 10-year cumulative incidence of IBTR, APBI might be an acceptable alternative for some women. FUNDING: National Cancer Institute, US Department of Health and Human Services.

Dispositional optimism and physical health: A long look back, a quick look forward.

Dispositional optimism is the generalized, relatively stable tendency to expect good outcomes across important life domains. This article provides a representative review of 30 years of research on dispositional optimism and physical well-being. Assessment of optimism is described, along with data regarding its stability. A review of the research linking optimism and physical health is then presented. Included in the review are initial studies suggesting that optimism and physical well-being might be linked as well as more recent, larger scale epidemiological studies that make the point more emphatically. Also considered are potential pathways-behavioral, biological, and social-that might explain these associations. The article concludes with a brief look to the future, describing several issues and questions that still need to be answered. These questions include the relationship of optimism and pessimism to each other (and the implications of that relationship for physical well-being), the origins of optimism and pessimism, and interventions that might be implemented to reduce the negative impact of a pessimistic outlook. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Cigarette tax rates, behavioral disengagement, and quit ratios among daily smokers.

Cigarette taxation is an economics-based policy associated with increased population-level quit ratios. However, the estimated effects of tax increase on smoking behavior vary substantially, underscoring the need to identify moderating variables. We examined whether behavioral disengagement - the tendency to abandon goals when experiencing stress - modified the association between cigarette taxes and daily smoking behavior. We connected state-level cigarette tax rate data with individual-level behavioral data, including a national sample of 725 US adults who smoked daily at baseline and reported follow-up data approximately 10 years later, and 376 who were resampled a third time after another 10 years. Analyses involved multilevel logistic regression (with time as a nested variable and anonymized state codes as a grouping variable), where current smoking status (dichotomous) was regressed on behavioral disengagement, state-level cigarette tax at baseline and current time, and the interaction between disengagement and current tax. Consistent with hypotheses, tax rate interacted with disengagement (OR=0.95, 95% CI=0.90,0.99, p=.0255): Among those one SD above the mean for disengagement, tax rate was unassociated with quit ratio (OR=0.99, 95% CI=0.85,1.16, p=.6975). However, among those one SD below the mean, tax rate was significantly associated with higher quit ratio (OR=1.22, 95% CI=1.04,1.43, p=.0163). Our data suggest the possibility that cigarette taxes may be more effective in facilitating cessation among smokers low in behavioral disengagement or when accompanied by interventions that reduce stress or maintain goal pursuit. Identifying psychological moderators of policy effectiveness holds promise for improving policy design and targeting.

Putting the life in lifestyle: Lifestyle choices after a diagnosis of cancer predicts overall survival.

BACKGROUND: The aim of this study was to examine predictors of health behaviors over time and the link between health behaviors and survival after a diagnosis of advanced cancer. METHODS: Patients with a diagnosis of advanced cancer were administered a battery of questionnaires measuring optimism, depressive symptoms, physical activity, intake of fruits and vegetables, and alcohol and tobacco use over an 18-month period. Analyses included generalized linear mixed models and Cox regression survival analyses. RESULTS: Of the 334 patients enrolled in the study, the mean age at cancer diagnosis was 62 years; the majority were male (62.3%) and white (91%). Twenty percent of the patients reported using alcohol, 19% reported using tobacco, 19% reported eating fewer fruits and vegetables than recommended by the Centers for Disease Control and Prevention and 28% reported physical inactivity after the diagnosis of advanced cancer. Clinical levels of depressive symptoms were associated with lower intake of fruits and vegetables (t = 2.67, P = .007) and physical inactivity (t = 2.11, P = .035). Dispositional optimism was positively associated with physical activity (t = -2.16, P = .031) and a lower frequency of tobacco use (Z = -2.42, P = .015). Multivariate analyses revealed that after adjusting for demographic variables (age and sex), depressive symptoms, and disease-specific factors (diagnosis, tumor size, cirrhosis, vascular invasion, and number of lesions), alcohol use (χ2 = 4.1186, P = .042) and physical inactivity (χ2 = 5.6050, P = .018) were linked to an poorer survival. CONCLUSIONS: Greater dissemination and implementation of effective interventions to reduce alcohol use and increase physical activity in cancer patients are recommended.

The whole is not the sum of its parts: Specific types of positive affect influence sleep differentially.

Given the known detrimental effects of poor sleep on an array of psychological and physical health processes, it is critical to understand the factors that protect sleep, especially during times of stress when sleep particularly suffers. Positive affect (PA) arises as a variable of interest given its known associations with health and health behaviors and its ability to buffer stress. In 2 studies, we examined which types of PA (distinguished by arousal level and trait/state measurement) were most beneficial for sleep and whether these associations varied depending on the stress context. In Study 1, college students (N = 99) reported on their PA and sleep during the week of a major exam. In Study 2, 2 weeks of daily PA and sleep data were collected during a period with no examinations in a similar sample of students (N = 83). Results indicated that high trait vigor was tied to better sleep efficiency and quality, especially during high stress. Trait calm was generally unhelpful to sleep, and was related negatively to sleep duration. State calm, on the other hand, interacted with stress in Study 2 to predict more efficient day-to-day sleep on days with higher average stress. These findings illustrate the importance of considering arousal level, affect duration, and the stress context in studies of PA and health. (PsycINFO Database Record

Are Optimism and Cynical Hostility Associated with Smoking Cessation in Older Women?

BACKGROUND: Optimism and cynical hostility independently predict morbidity and mortality in Women's Health Initiative (WHI) participants and are associated with current smoking. However, their association with smoking cessation in older women is unknown. PURPOSE: The purpose of this study is to test whether optimism (positive future expectations) or cynical hostility (mistrust of others) predicts smoking cessation in older women. METHODS: Self-reported smoking status was assessed at years 1, 3, and 6 after study entry for WHI baseline smokers who were not missing optimism or cynical hostility scores (n = 10,242). Questionnaires at study entry assessed optimism (Life Orientation Test-Revised) and cynical hostility (Cook-Medley, cynical hostility subscale). Generalized linear mixed models adjusted for sociodemographics, lifestyle factors, and medical and psychosocial characteristics including depressive symptoms. RESULTS: After full covariate adjustment, optimism was not related to smoking cessation. Each 1-point increase in baseline cynical hostility score was associated with 5% lower odds of cessation over 6 years (OR = 0.95, CI = 0.92-0.98, p = 0.0017). CONCLUSIONS: In aging postmenopausal women, greater cynical hostility predicts lower smoking cessation over time. Future studies should examine whether individuals with this trait may benefit from more intensive cessation resources or whether attempting to mitigate cynical hostility itself may aid smoking cessation.

Do the Emotional Benefits of Optimism Vary Across Older Adulthood? A Life Span Perspective.

This study examined whether the emotional benefits of dispositional optimism for managing stressful encounters decrease across older adulthood. Such an effect might emerge because age-related declines in opportunities for overcoming stressors could reduce the effectiveness of optimism. This hypothesis was tested in a 6-year longitudinal study of 171 community-dwelling older adults (age range = 64-90 years). Hierarchical linear models showed that dispositional optimism protected relatively young participants from exhibiting elevations in depressive symptoms over time, but that these benefits became increasingly reduced among their older counterparts. Moreover, the findings showed that an age-related association between optimism and depressive symptoms was observed particularly during periods of enhanced, as compared to reduced, stress. These results suggest that dispositional optimism protects emotional well-being during the early phases of older adulthood, but that its effects are reduced in advanced old age.

The Benefits of Goal Adjustment Capacities for Well-Being Among Women With Breast Cancer: Potential Mechanisms of Action.

Breast cancer can seriously disrupt a person's important life goals. As such, the ability to adjust one's goals may be critical for well-being. The present study investigated the relationships between disengagement/reengagement capacity and well-being among women with breast cancer, as well as several potential mechanisms (intrusive thoughts, life purpose, and physical activity) that could explain these relationships. The sample consisted of 230 women with early-stage (n = 172) or late-stage (n = 58) breast cancer, who were followed prospectively for 8 months. Well-being measures consisted of global mental health, perceived physical health, positive/negative affect, and sleep efficiency. Disengagement capacity did not predict any outcome variable. In contrast, reengagement capacity prospectively predicted changes in global mental health, positive affect, negative affect, sleep efficiency, life purpose, and physical activity. Life purpose mediated the prospective relationship between reengagement capacity and multiple aspects of well-being. The relationships between purpose and positive/negative affect were reciprocal over time. Results also suggested that physical activity is not a mediator, but is in fact a result of the effect of reengagement capacity on well-being. The results demonstrate that reengagement capacity is important for well-being among women with breast cancer.

Testing the Independence of Multiple Personality Factors in Relation to Health Among Community-Dwelling Older Men.

OBJECTIVE: We assessed associations between specific personality factors and health, and tested whether specific personality factors were related to health outcomes independent of each other. METHOD: We performed cross-sectional analyses of personality and health among a sample of community-dwelling older men (n = 613, M age = 81.4, SD = 5.04 years) living in Pittsburgh, Pennsylvania. RESULTS: Personality factors (dispositional optimism, conscientiousness, and goal adjustment) were crudely related to both physical and mental health, but adjusting for other personality factors completely attenuated several of these associations. Conscientiousness remained uniquely related to every physical and mental health outcome. Optimism remained uniquely related to all health outcomes, except physical activity (which was more highly related to conscientiousness and goal adjustment). Associations between goal adjustment and probable depression appeared to be explained by conscientiousness and optimism. DISCUSSION: Correlations among multiple aspects of personality may mask unique associations of specific personality aspects with successful aging.

Randomized psychosocial interventions for breast cancer: impact on life purpose.

OBJECTIVE: The present study sought to identify mediators underlying the effects of an education and a peer support intervention for women with breast cancer and to determine if the efficacy of a peer support intervention is moderated by cancer severity. METHODS: Participants included 180 patients with early stage (I or II) and 65 patients with late stage (IV) breast cancer. The study was originally planned as a 2 (early stage, late stage) × 3 (education intervention, peer support intervention, control condition) design; however, the education condition for the late stage cancer group was dropped, because of slow recruitment. Participants completed measures of well-being prior to being randomized (Time 1), then again 2 weeks after the group meetings ended (Time 2), and 6 months later (Time 3). RESULTS: Among the participants who had attended at least one group meeting, the education intervention predicted more life purpose and marginally predicted more perceived physical health at Time 2. The peer support intervention predicted more life purpose and less depressive symptoms at Time 2. Cancer severity did not moderate these effects. The effect of the peer support intervention on depressive symptoms was mediated by life purpose. None of the intervention effects were evident at Time 3. CONCLUSIONS: Peer support interventions have positive short-term effects on well-being, among women with late and early stage breast cancer, and these effects are partially mediated by changes in life purpose. Education interventions have positive short-term effects on well-being among women with early stage breast cancer. Copyright © 2015 John Wiley & Sons, Ltd.

Rediscovering confidence as a mechanism and optimism as a construct.

The target article asserts that resilience results from a generalized tendency to appraise stressful circumstances positively. Apparently unbeknownst to the authors, essentially the same idea has been advanced before and studied extensively from a different research perspective. This raises a broader issue: the critical need, when projects attempt to span disciplines, to fully examine work from all relevant backgrounds.

Dispositional optimism.

Optimism is a cognitive construct (expectancies regarding future outcomes) that also relates to motivation: optimistic people exert effort, whereas pessimistic people disengage from effort. Study of optimism began largely in health contexts, finding positive associations between optimism and markers of better psychological and physical health. Physical health effects likely occur through differences in both health-promoting behaviors and physiological concomitants of coping. Recently, the scientific study of optimism has extended to the realm of social relations: new evidence indicates that optimists have better social connections, partly because they work harder at them. In this review, we examine the myriad ways this trait can benefit an individual, and our current understanding of the biological basis of optimism.

Associations between dispositional optimism and diurnal cortisol in a community sample: when stress is perceived as higher than normal.

OBJECTIVES: This study examined whether dispositional optimism would be associated with reduced levels of cortisol secretion among individuals who perceive stress levels that are either higher than their normal average (i.e., within-person associations) or higher than the stress levels of other individuals (i.e., between-person associations). METHODS: Stress perceptions and four indicators of diurnal cortisol (area-under-the-curve, awakening, afternoon/evening, and cortisol awakening response [CAR] levels) were assessed on 12 different days over 6 years in a sample of 135 community-dwelling older adults. RESULTS: Hierarchical linear models showed that although pessimists secreted relatively elevated area-under-the-curve, awakening, and afternoon/evening levels of cortisol (but not CAR) on days they perceived stress levels that were higher than their normal average, optimists were protected from these stress-related elevations in cortisol. However, when absolute stress levels were compared across participants, there was only a significant effect for predicting CAR (but not the other cortisol measures), indicating that optimism was associated particularly strongly with a reduced CAR among participants who experienced high levels of stress. CONCLUSIONS: Dispositional optimism can buffer the association between stress perceptions and elevated levels of diurnal cortisol when individuals perceive higher-than-normal levels of stress, and it may predict a reduced CAR among individuals who generally perceive high stress levels. Research should examine relative, in addition to absolute, levels of stress to identify the personality factors that help individuals adjust to psychological perceptions of stress.

Goal Adjustment Capacities, Subjective Well-Being, and Physical Health.

This article addresses how individuals can adjust to the experience of unattainable goals and protect their subjective well-being and physical health. We discuss theoretical aspects involved in the self-regulation of unattainable goals and point to the importance of general individual differences in goal disengagement and goal reengagement capacities. In addition, we review the extant literature, suggesting that goal disengagement capacities can reduce psychological distress and ameliorate patterns of biological dysregulation and physical health problems if individuals experience unattainable goals. Goal reengagement capacities, by contrast, are shown to be associated with positive indicators of subjective well-being (e.g., positive affect or purpose in life), but rarely predict psychological distress or physical health outcomes. We finally address several remaining issues that have become apparent in the extant literature and may deserve more attention in future research.

Optimism, response to treatment of depression, and rehospitalization after coronary artery bypass graft surgery.

OBJECTIVE: Optimism has been associated with a lower risk of rehospitalization after coronary artery bypass graft (CABG) surgery, but little is known about how optimism affects treatment of depression in post-CABG patients. METHODS: Using data from a collaborative care intervention trial for post-CABG depression, we conducted exploratory post hoc analyses of 284 depressed post-CABG patients (2-week posthospitalization score in the 9-item Patient Health Questionnaire ≥ 10) and 146 controls without depression who completed the Life Orientation Test - Revised (full scale and subscale) to assess dispositional optimism. We classified patients as optimists and pessimists based on the sample-specific Life Orientation Test - Revised distributions in each cohort (full sample, depressed, nondepressed). For 8 months, we assessed health-related quality of life (using the 36-item Short-Form Health Survey) and mood symptoms (using the Hamilton Rating Scale for Depression [HRS-D]) and adjudicated all-cause rehospitalization. We defined treatment response as a 50% or higher decline in HRS-D score from baseline. RESULTS: Compared with pessimists, optimists had lower baseline mean HRS-D scores (8 versus 15, p = .001). Among depressed patients, optimists were more likely to respond to treatment at 8 months (58% versus 27%, odds ratio = 3.02, 95% confidence interval = 1.28-7.13, p = .01), a finding that was not sustained in the intervention group. The optimism subscale, but not the pessimism subscale, predicted treatment response. By 8 months, optimists were less likely to be rehospitalized (odds ratio = 0.54, 95% confidence interval = 0.32-0.93, p = .03). CONCLUSIONS: Among depressed post-CABG patients, optimists responded to depression treatment at higher rates. Independent of depression, optimists were less likely to be rehospitalized by 8 months after CABG. Further research should explore the impact of optimism on these and other important long-term post-CABG outcomes.